Patient and family organization perspectives on poor treatment in Swedish adult psychiatric care

Respect and integrity are fundamental to effective psychiatric care, yet patient experiences of poor treatment remain a significant concern. This study explores patient perspectives on mistreatment within Swedish adult psychiatry through focus group interviews with representatives of patient and family organizations. Participants described systemic and interpersonal challenges that contribute to inadequate care, identifying four main themes: inaccessibility of psychiatric services, lack of collaboration between patients and healthcare providers, absence of a holistic perspective on patients, and a stark power imbalance between vulnerable individuals and an authoritative psychiatric system. Structural barriers, including long wait times and limited treatment options, were perceived as forms of neglect, leaving patients struggling to access necessary care. Patients frequently felt excluded from decision-making, as their lived experiences were often dismissed in favor of standardized treatment protocols. This lack of recognition was further compounded by epistemic injustice, where patients' accounts were deemed unreliable due to prevailing biases against psychiatric populations. Participants emphasized the emotional toll of dismissive encounters, with many patients reporting feelings of helplessness, mistrust, and self-doubt. The study highlights the urgent need for reforms that prioritize respect, collaboration, and patient-centered care in psychiatric settings. Addressing these concerns requires systemic changes to reduce barriers to care, improve communication, and ensure that psychiatric patients are treated as credible, autonomous individuals. By acknowledging patient perspectives, psychiatric care can foster greater trust, improve adherence to treatment, and ultimately enhance mental health outcomes.